Active NPI
Irina Churbakov
- Adult Health Nurse Practitioner
- Rego Park, NY
National Provider Identifier
1588224828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- F305291-1
- Practice address
- 6536 99TH St
Rego Park, NY 11374-4358 - Phone
- (718) 459-0700
- NPI assigned
- Jun 18, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | F305291-1 | NY | Primary |
Addresses
Primary practice location
6536 99TH St
Rego Park, NY 11374-4358
Mailing address
6536 99TH St
Rego Park, NY 11374-4358
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F305291-1 | NY | MD | Adult Health Nurse Practitioner |
Networks
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560816000000",
"number": "1588224828",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6536 99TH ST",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6536 99TH ST",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744358",
"telephone_number": "718-459-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURBAKOV",
"first_name": "IRINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-18",
"last_updated": "2019-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "F305291-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.